What Is Traction?

In the medical field, traction refers to the practice of slowly and gently pulling on a fractured or dislocated body part. Its
often done using ropes, pulleys, and weights. These tools help apply force to the tissues surrounding the damaged area.

The purpose of traction is to guide the body part back into place and hold it steady. Traction may be used to:

stabilize and realign bone fractures, such as a broken arm or leg

help reduce the pain of a fracture before surgery

treat bone deformities caused by certain conditions, such as scoliosis

correct stiff and constricted muscles, joints, tendons, or skin

stretch the neck and prevent painful muscle spasms

What Are the Different Types of Traction?

The two main types of traction are skeletal traction and skin traction. The type of traction used will depend on the
location and the nature of the problem.

Skeletal Traction

Skeletal traction involves placing a pin, wire, or screw in the fractured bone. After one of these devices has been
inserted, weights are attached to it so the bone can be pulled into the correct position. This type of surgery may
be done using a general, spinal, or local anesthetic to keep you from feeling pain during the procedure.

The amount of time needed to perform skeletal traction will depend on whether its a preparation for a more
definitive procedure or the only surgery thatll be done to allow the bone to heal.

Skeletal traction is most commonly used to treat fractures of the femur, or thighbone. Its also the preferred
method when greater force needs to be applied to the affected area. The force is directly applied to the bone,
which means more weight can be added with less risk of damaging the surrounding soft tissues.

Skin Traction

Skin traction is far less invasive than skeletal traction. It involves applying splints, bandages, or adhesive tapes to
the skin directly below the fracture. Once the material has been applied, weights are fastened to it. The affected
body part is then pulled into the right position using a pulley system attached to the hospital bed.

Skin traction is used when the soft tissues, such as the muscles and tendons, need to be repaired. Less force is
applied during skin traction to avoid irritating or damaging the skin and other soft tissues. Skin traction is rarely
the only treatment needed. Instead, its usually used as a temporary way to stabilize a broken bone until the
definitive surgery is performed.
 APPLYING TRACTION
PROCEDURE RATIONALE
1. Check the order. The order will state the type of - The order for traction is written by the physician and
traction to be used, the weight to be applied, and should be followed accurately by the nurse.
the allowances for restriction on the activity of the
client.
- To prevent the complication of immobilization.
2. Assess the client for possible complication of
traction. It is essential to make a careful assessment
of the client initially, and at regular interval
thereafter. The assessment should include all
systems with special emphasis on circulation, motor
function, and sensation in any extremity affected. If
circulation for example is less than adequate, special
padding over bony prominences may have to be
added to prevent skin breakdown.
3. Wash your hands. - For infection control.
4. Ensure that an assistance you might need will be
available.
5. Gather the equipment you need. Skin traction will
make use of several of the following: solutions,
taoes, boots, bandages, harness, ropes, pulleys,
weights, padding, trapeze, spreadbars, footrests and
footboards.
6. Identify the client. - To be sure you are carrying the procedure for the correct
7. Explain the procedure. Find out what the client.
physician has told the client and explain the purpose
of the traction, whether weights are to be used
intermittently or continuously and how much the
client will be allowed to turn or move. Some client in
traction cannot move as much as those in
intermittent skin traction.
8. Provide for privacy and drape the client as
appropriate.
9. Place the bed in proper position. - The degree of pull tension required for the effective
10. Cleanse and prepare the skin according to the traction often depends on the level of the bed and the
procedure of the facility. If tape is to applied the skin relative position of the client. With some types of skin
is often shaved beforehand so that pain when tape is traction, the clients body weight serves as the
being removed will be lessened. Tincture of benzoin counterbalance necessitating elevation of the foot or the
solution maybe applied to protect the skin before head of the bed.
any type of skin traction is initiated.
11. To secure the traction, apply the type, boots,
slings, or halters, appropriate to the specific
procedure. Make sure all appliances are the right size
for the particular client.
12. Thread and not ropes through lubricated pulleys.
Check that both are aligned properly for the traction
you are carrying out.
13. Using the hooks provided, attach the ropes to the
clients appliance. Check for the security of the
tapes, boot, or wrappings by gently tugging on the
attached rope.
14. If more than one weight is to be applied, add one
at a time with a gentle motion.
15. Tape the end of the rope.
16. Carefully check that all appliances are
functioning effectively. - To avoid jerking the body part.
17. Place the Call signal, all personal possessions,
and items needed for self care with easy reach. - To avoid fraying.
18. Evaluate the following:
a. Is the client comfortable?
b. Are all ropes, pulleys, and weights correctly - Having to reach for objects or call signal could not only
placed and unobstructed. misalign the traction but cause a fall.
c. Are the skeletal pin sites free of
inflammation or infection.
d. Does the client show any signs of
complication of immobility especially skin
breakdown?
19. Make any necessary adjustments. You may need
to add paddings to bony prominences. Take care not
to exert any additional pressure when adding
padding. Ropes and pulleys may also need some
adjustments. - To correct alignment.
20. Wash your hands for infection control.
21. Chart the type of traction applied, any
observation or concerns, and the clients tolerance
of the procedure.
What Is a Splint?

A splint is a piece of medical equipment used to keep an injured body part from moving and to protect it from any
further damage.

A splint is often used to stabilize a broken bone while the injured person is taken to the hospital for more advanced
treatment. It can also be used if you have a severe strain or sprain in one of your limbs. Placed properly, a splint will help
ease the pain of an injury by making sure that the wounded area does not move.

Indications for Splinting

Acute arthritis, including acute gout

Severe contusions and abrasions

Skin lacerations that cross joints

Tendon lacerations

Tenosynovitis

Puncture wounds/bites to the hands, feet, and joints

Fractures and sprains

Reduced joint dislocations

Splinting Equipment

Stockinette

Splinting material

Plaster

Strips or rolls (2-, 3-, 4- or 6-inch widths)

Prefabricated Splint Rolls

Plaster

Fiberglass with polypropylene padding (at CMH)

Padding (Webril)

Ace Wrap

Bucket/receptacle of warm water

Trauma sheers
General Splinting Procedure

Measure and prepare the plaster

Apply the stockinette so that it extends 2 or 3 inches beyond the plaster

Apply 2 or 3 layers of Webril over the area to be splinted

Be generous

Avoid wrinkles

Place extra padding around bony prominences

Place Webril between digits that are going to be splinted to avoid maceration

Wet the plaster and place it over the area to be splinted

Submerge the premeasured plaster in unused warm water

Remove the splint from the water and squeeze out the excess water and remove wrinkles

Fold the ends of stockinette over the the plaster to smooth the edges of the splint

Place a layer of Webril over the plaster

Apply the ace wrap around the splint to secure it in place

Unwrap the bandage without placing too much tension around the extremity

While still wet, mold the plaster to conform to the shape of the extremity

Use the palms of your hand rather than the fingers

Place the patients extremity in the position desired

Keep the patient still until the splint has dried and hardened (the plaster will become warm as its
drying)

Fast-drying: 5-8 minutes

Extra-fast drying: 2-4 minutes

After the splint has dried, check the splinted extremity for function, arterial pulse, capillary refill, temperature of
skin, and sensation